NPIMap

Organization Active NPI

Taylor County

  • Early Intervention Provider Agency
  • Medford, WI
National Provider Identifier
1568645604
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
TAYLOR COUNTY
Practice address
540 College Ave
Medford, WI 54451-2027
Phone
(715) 748-3332
Fax
(715) 748-3342
NPI assigned
Dec 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Susan Hady
Title
Director
Phone
(715) 748-3332

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

540 College Ave
Medford, WI 54451-2027

Mailing address

540 College Ave
Medford, WI 54451-2027
Phone (715) 748-3332

Other identifiers 1

IdentifierTypeStateIssuer
41223400MedicaidWI

Other names 1

  • Taylor County Human Services Department Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080229000477 WI Part B Supplier - Clinic/Group Practice 4082798905 Receives reassigned benefits from 4 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Medford, WI

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Taylor Cty Nurs Serv9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1568645604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 COLLEGE AVE",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544512027",
            "telephone_number": "715-748-3332",
            "fax_number": "715-748-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 COLLEGE AVE",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544512027",
            "telephone_number": "715-748-3332",
            "fax_number": "715-748-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAYLOR COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-12",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "HADY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "715-748-3332"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41223400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Taylor County Human Services Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Medford, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.